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How Severe Is Prostate Cancer

Why Does Prostate Cancer Happen

Chronic Inflammation & Prostate Cancer

The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.

The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.

For reasons not yet understood, prostate cancer is more common in men of African-Caribbean or African descent, and less common in Asian men.

Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.

Recent research also suggests that obesity increases the risk of prostate cancer.

The Top 7 Signs Of Advanced Prostate Cancer

In the early stages, you may not notice any symptoms related to prostate cancer. This is why screenings are important. Symptoms can sometimes be noticed for the first time when the cancer advances.

Advanced prostate cancer, also called metastatic cancer, means the cancer has spread to other areas of your body beyond your prostate gland. The most common areas for prostate cancer to spread are your bladder, rectum, and bones. It can also spread to your lymph nodes, liver, lungs, and other body tissues.

Whether youve just been diagnosed or youre in treatment, its also important to know the signs of advanced cancer. Cancer can behave differently depending on your genetics, so not every person will experience the same symptoms in the same way.

Read on to learn more about the seven top symptoms of advanced prostate cancer and how to spot them.

What Are Possible Side Effects Of Treatments For Localized Prostate Cancer

All treatments can cause side effects. The most common side effects are urinary, bowel, and sexual problems. Some problems happen soon after treatment, but others develop over time. Some side effects may get better, but some may last a long time or may never go away. Talk with your doctor if you have any side effects. There may be ways to help manage them.

Table 2. Possible side effects of treatments

Treatment
  • Weakened bones that may break more easily
Some types of hormone therapy may increase the risk of a heart attack or stroke.

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Prostate Cancer Caregiver Podcast Series

We are proud to announce a new podcast series geared toward helping give support, hope and guidance to prostate cancer caregivers. The goal of this Prostate Cancer Caregiver Podcast Series is to help others connect with a diverse group of people who have felt the impact of prostate cancer in their lives and empower them on their journey.

Money And Financial Support

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If you have to reduce or stop work because of your prostate cancer, you may find it hard to cope financially. If you have prostate cancer or are caring for someone who does, you may be entitled to financial support:

  • if you have a job but cannot work because of your illness, you’re entitled to Statutory Sick Pay from your employer
  • if you do not have a job and cannot work because of your illness, you may be entitled to Employment and Support Allowance
  • if you are caring for someone with cancer, you may be entitled to Carer’s Allowance
  • you may be eligible for other benefits if you have children living at home or if you have a low household income

Find out early what help is available to you. Speak to the social worker at your hospital, who can give you the information you need.

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Survival For All Stages Of Prostate Cancer

Generally for men with prostate cancer in England:

  • more than 95 out of 100 will survive their cancer for 1 year or more
  • more than 85 out of 100 will survive their cancer for 5 years or more
  • almost 80 out of 100 will survive their cancer for 10 years or more

Survival for prostate cancer is also reported in Scotland and Northern Ireland. But it is difficult to compare survival between these countries because of differences in the way the information is collected.

Cancer survival by stage at diagnosis for England, 2019Office for National Statistics

These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account the background mortality that they would have experienced if they had not had cancer.

Questions You May Want To Consider Asking Your Doctor Include:

  • What type of prostate problem do I have?
  • Is more testing needed and what will it tell me?
  • If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
  • What type of treatment do you recommend for my prostate problem?
  • For men like me, has this treatment worked?
  • How soon would I need to start treatment and how long would it last?
  • Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
  • What are the side effects of the medicine?
  • Are there other medicines that could interfere with this medication?
  • If I need surgery, what are the benefits and risks?
  • Would I have any side effects from surgery that could affect my quality of life?
  • Are these side effects temporary or permanent?
  • How long is recovery time after surgery?
  • Will I be able to fully return to normal?
  • How will this affect my sex life?
  • How often should I visit the doctor to monitor my condition?
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Prostate Cancer Survival Rates Are Favorable Overall

Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.

To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what’s called the relative survival rate for prostate cancer.

Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we’re not counting men with prostate cancer who die of other causes:

  • 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
  • Fewer men have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread of prostate cancer, about one-third will survive for five years after diagnosis.

Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:

  • the relative 10-year survival rate is 98%
  • the relative 15-year survival rate is 96%

Who Is At Risk For Prostate Cancer

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All men are at risk for prostate cancer, but African-American men are more likely to get prostate cancer than other men.

All men are at risk for prostate cancer. Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and about 2 to 3 men will die from prostate cancer.

The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer.

Some men are at increased risk for prostate cancer. You are at increased risk for getting or dying from prostate cancer if you are African-American or have a family history of prostate cancer.

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Should You Know Your Psa Level

Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.

If you’re a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they can arrange for it to be carried out free on the NHS.

If results show you have a raised level of PSA, your GP may suggest further tests.

Outlook For Men With Advanced Prostate Cancer

While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.

Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer.

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What Is Evaluation Of The Primary Tumor In Prostate Cancer

Evaluation of the tumor :

  • TX: Cannot evaluate the primary tumor.
  • T0: No evidence of tumor.
  • T1: Tumor present but not detectable clinically or with imaging.
  • T1a: The tumor was incidentally found in less than 5% of prostate tissue resected .
  • T1b: The tumor was incidentally found in greater than 5% of prostate tissue resected.
  • T1c: The tumor was found in a needle biopsy performed due to an elevated serum PSA.
  • T2: The tumor can be felt on examination but has not spread outside the prostate.
  • T2a: The tumor is in half or less than half of one of the prostate gland’s two lobes.
  • T2b: The tumor is in more than half of one lobe but not both.
  • T2c: The tumor is in both lobes.
  • T3: The tumor has spread through the prostatic capsule .
  • T3a: The tumor has spread through the capsule on one or both sides.
  • T3b: The tumor has invaded one or both seminal vesicles.
  • T4: The tumor has invaded other nearby structures.
  • It should be stressed that the designation “T2c” implies a tumor which is palpable in both lobes of the prostate. Tumors which are found to be bilateral on biopsy only but are not palpable bilaterally should not be staged as T2c.

    Evaluation of the regional lymph nodes :

    • NX: The regional lymph nodes cannot be evaluated.
    • N0: There has been no spread to the regional lymph nodes.
    • N1: There has been spread to the regional lymph nodes.

    Evaluation of distant metastasis :

    What Are Other Local Treatment Options For Prostate Cancer

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    Besides radical prostatectomy, external beam radiation and/or brachytherapy, cryosurgical ablation of the prostate and high-intensity focused ultrasound have emerged as alternative therapeutic options in patients with clinically localized prostate cancer.

    Cryotherapy and high-intensity focused ultrasound has been used to destroy tissue, either by freezing or by generating local thermal energy. These techniques can be applied focally, sub-totally, or to the entire prostate gland. However, the role of these techniques remains uncertain. Potential advantages in men with the localized disease include the ability to destroy cancer cells using a relatively noninvasive procedure. As such, these procedures are associated with minimal blood loss and pain. There is also faster post-treatment convalescence.

    Cryotherapy

    This technique involves inserting a probe through a small skin incision and freezing areas of cancer in the prostate.

    HIFU

    • HIFU was first developed as a treatment for benign prostatic hyperplasia and is now also being used as a procedure for the killing of prostate cancer cells. This procedure utilizes transrectal ultrasound that is highly focused into a small area, creating intense heat of 80° C to 100° C, which is lethal to prostate cancer tissue.
    • The published clinical experience with HIFU for this application is limited and the procedure is not yet approved by the FDA for use in the U.S.

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    Bone Loss From Prostate Cancer Treatment

    Testosterone, the male sex hormone, fuels the growth of prostate cancer but it also is crucial to bone health. Treatment of prostate cancer with hormone therapy, also called androgen deprivation therapy , blocks the production of testosterone which stops or slows the growth of the cancer. Without testosterone, bones can become weak and break more easily. When a man is on ADT recovery from a bone fracture takes longer than for other men. It is especially important for men taking ADT to speak with their physician about how to plan for and manage the bone loss before a problem arises. Bone strength can also be decreased as a result of radiation and chemotherapy used to treat prostate cancer.

    Fortunately there are ways to strengthen and repair your bones including medicines and lifestyle changes.

    • Bisphosphonates can prevent the thinning of the bone and help make them stronger
    • Oral bisphosphonates include Fosamax and Actonel
    • The intravenous bisphosphonate is Zometa
    • Strive for a healthy diet and make sure to get enough calcium and vitamin D
    • When exercising, include weight bearing and muscle strengthening exercises
    • Avoid tobacco and excessive alcohol

    Learn

    Effects On Pituitary System

    commonly develops after radiation therapy for sellar and parasellar neoplasms, extrasellar brain tumours, head and neck tumours, and following whole body irradiation for systemic malignancies. Radiation-induced hypopituitarism mainly affects and . In contrast, and deficiencies are the least common among people with radiation-induced hypopituitarism. Changes in -secretion is usually mild, and vasopressin deficiency appears to be very rare as a consequence of radiation.

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    Treatment Risks And Benefits

    There are risks and benefits of each type of therapy.

    Radiation therapy. Older studies show that about one-half of patients develop erectile dysfunction within 5 years of having radiation therapy. However, newer forms of radiation may have different outcomes.

    • Many men feel very tired at the end of the treatment period.
    • Erectile dysfunction is a common side effect and often gets worse over time.
    • Some men have side effects like urinary burning, urinary bleeding, frequent urination, rectal bleeding, rectal discomfort, or diarrhea during or shortly after the treatment.
    • More serious complications are rare. However, a degree of uncertainty goes along with radiation treatment. Since the prostate gland and the lymph nodes arent taken out, your doctor cant tell the exact size of the tumor. The cancer could come back many years after radiation treatment.

    Radical prostatectomy. The short-term risks of this surgery are low if youre young and in good health.

    The main risks of radical prostatectomy are incontinence and impotence.

    Hormone therapy. Hormone therapy often is used in combination with other treatments. It does have side effects.

    Chemotherapy. Chemotherapy has been shown to help some people who have advanced prostate cancer live longer.

    Chemotherapy can have many side effects, including hair loss, nausea, fatigue, and loss of taste.

    Who Is At Risk For Advanced Prostate Cancer

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    The exact cause of prostate cancer isnt clear. Your risk of developing this particular cancer increases after you reach age 50.

    Certain groups are more likely to develop aggressive forms of prostate cancer, including African-American men and men who carry certain inherited genetic mutations such as BRCA1, BRCA2, and HOXB13.

    Most men with prostate cancer dont always have a family history of the disease. But having a father or brother with prostate cancer more than doubles your risk.

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    Pearls And Other Issues

    PSA Testing: The Pros and the Cons

    Prostate Specific Antigen is a protein produced by the prostate and is abundant in semen. Its natural function is to divide seminogelin in the semen, which helps in liquefaction. The expression of PSA is androgen-regulated.

    It was originally used as a prostatic tissue stain to help determine the etiology of tumors of unknown origin. Later, serum levels of PSA were used as a prostate cancer screening tool because serum PSA levels start to increase significantly about seven to nine years before the clinical diagnosis of malignancy. While a good indicator of prostatic disorders, PSA elevation is not specific for cancer as it is also elevated in benign prostatic hyperplasia, infection, infarction, inflammation and after prostatic manipulation. It also cannot reliably distinguish between low risk/low grade disease and high risk/high grade cancers.

    About 80% of the patients currently diagnosed with prostate cancer are initially investigated due to an elevated serum PSA.

    While it unquestionably increases prostate cancer detection rates, the value of PSA testing is less clear in avoiding overtreatment, improving quality of life and lengthening overall survival which is why routine PSA screening for prostate cancer remains quite controversial.

    PSA testing became widely available in the United States in 1992, and since then, prostate cancer detection rates have increased substantially.

    The Current USPSTF Recommendation

    Against PSA Screenings

    General Prostate Cancer Survival Rate

    According to the American Cancer Society:

    • The relative 5-year survival rate is nearly 100%
    • The relative 10-year survival rate is 98%
    • The 15-year relative survival rate is 91%

    Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.

    Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology

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    Prostate Cancer Survival Rates

    Answering the question of how curable is prostate cancer? first requires understanding what doctors mean when they refer to curability. Regardless of the type of cancer, doctors consider cancer cured when a patient remains cancer-free for a specified period after treatment. The higher the number of patients who stay cancer-free for five years or longer, the higher the curability of that particular disease.

    Prostate cancer, therefore, has one of the highest curability rates of all types of cancer, thanks in large part to early detection standards and advances in treatment, such as the stereotactic body radiation therapy offered by Pasadena CyberKnife. When the cancer is detected in the early local or regional stages that is, before the cancer has spread or when it has only spread to limited areas in the pelvic regions the five-year survival rate is nearly 100 percent.

    Survival rates decline significantly when cancer is detected at later stages however, the good news is that only about five percent of men are diagnosed after the cancer has become widespread throughout the body. In short, more than 90 percent of men who are diagnosed with prostate cancer live for five years or longer after treatment, making it one of the most curable forms of cancer.

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